Miscellaneous Texas Tax Forms-66-101 Texas Coastal Protection Fee Report - Supplement

1. 66-101
(Rev.3-02/3)
b.
TEXAS COASTAL PROTECTION FEE REPORT - SUPPLEMENT
Use this form to identify owners who paid the Coastal Protection Fee on oil
transferred through YOUR terminal. USE A SEPARATE PAGE FOR EACH TERMINAL.
ENTER WHOLE BARRELS ONLY
DO NOT WRITE IN SHADED AREAS
e. f. Due date
d. Filing period
c. Fee payer number
g. Fee payer name
1.Terminal identification (Same as Item 2 on the report form)
3. NUMBER OF BARRELS
2. NAME(S) OF OWNER(S) PAYING COASTAL PROTECTION FEE TRANSFERRED
4. TOTAL NUMBER OF BARRELS TRANSFERRED
(Should equal the amount in Item 5 of the report for this terminal and this period)

2. 66-101 (Back) (Rev.3-02/3)
INSTRUCTIONS FOR COMPLETING TEXAS COASTAL PROTECTION FEE REPORT - SUPPLEMENT
Under Ch. 559, Government Code, you are entitled to review, request, and correct information we have on file about you, with limited
exceptions in accordance with Ch. 552, Government Code. To request information for review or to request error correction, contact us at the
address or toll-free number listed on this form.
WHO MUST FILE - Every person (sole owner, partnership, corporation or other organization) who files the Texas Coastal Protection Fee
Report, Form 66-100, and who shows a deduction in Item 5 on that report, quot;Barrels with fee paid by owner,quot; must file this supplement.
Complete and detailed records must be kept of all crude oil, including condensate, on which the fee is not collected.
WHEN TO FILE - This supplement must be filed with the Coastal Protection Fee Report.
AMENDED REPORT - If you are filing an amended report, write the word quot;AMENDEDquot; on the front of this form above the title. The
amended report must be complete using replacement figures NOT NET ADJUSTMENTS.
FOR ASSISTANCE - For assistance with any Coastal Protection Fee question, please contact the Texas State Comptroller's Office at
1-800-252-1384 toll free nationwide, or call 512/463-4600. (From a Telecommunication Device for the Deaf (TDD) ONLY call 1-800-248-4099
toll free, or call 512/463-4621.)
Please do not write in shaded areas.
GENERAL INSTRUCTIONS -
TYPE OR PRINT.
Use a separate supplement for each terminal where a deduction is shown in
Item 5 on the report.
If additional pages are needed, photocopies of this page, computer generated
pages or other types of continuations may be attached.
SPECIFIC INSTRUCTIONS -
Item 1 - TERMINAL IDENTIFICATION: Enter the name and/or location of the terminal for which this supplement applies. This should be
the same as the entry in Item 2 on the report form.
Item 2 - NAME(S) OF OWNER(S) PAYING COASTAL PROTECTION FEE: Enter the name of each party from which you have
documentation that they will pay the fee directly to the Comptroller for the crude oil/condensate they own in your terminal.
Item 3 - NUMBER OF BARRELS TRANSFERRED: Enter the number of barrels for which the listed party has provided documentation
that they will pay the fee directly to the Comptroller.
Item 4 - TOTAL NUMBER OF BARRELS TRANSFERRED: Use this item to total the number of barrels on which the owners are to pay
the fee directly to the Comptroller for this terminal. This number should match Item 5 for this terminal on the report form.